Svensson O, Karlsson J E, Binner L, Brobe R, Höhler H, Kreuzer J, Malm D, Matheis G, Pietersen A, Schenkel W
Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden.
Pacing Clin Electrophysiol. 1994 Nov;17(11 Pt 2):2008-11. doi: 10.1111/j.1540-8159.1994.tb03790.x.
The aim of this study was to evaluate whether steroid membrane leads can reduce pacing thresholds and thereby save energy as compared to nonsteroid membrane leads. The study was a random sample, double blind test consisting of 90 patients between 49-94 years of age admitted to seven hospitals in Europe for pacemaker implantation. The two leads compared in this study had contoured activated carbon tips covered with ion exchange membranes. The leads were identical except that 30 micrograms of dexamethasone was dissolved in the ion exchange membrane of one of the leads. Normal lead implant procedures were used. Follow-up procedures were conducted at 2 weeks and 1, 3, 6, and 12 months after lead implantation. The pulse generator was programmed to an amplitude of 2.5 or 5 V and a duration of 0.5 msec. The stimulation threshold was measured using the VARIO function. The threshold was measured a total of three times in order to determine the presence of microdislocations. At the 2- and 4-week follow-ups, the stimulation threshold was significantly lower for the steroid leads than for the membrane leads without steroid (0.54 +/- 0.19 vs 0.76 +/- 0.25 V, P = 0.0005; and 0.59 +/- 0.19 vs 0.74 +/- 0.26 V, P = 0.005), but after 3 months, the threshold values were almost the same for both leads.
本研究的目的是评估与非类固醇膜电极相比，类固醇膜电极是否能降低起搏阈值，从而节省能量。该研究是一项随机抽样、双盲试验，由欧洲七家医院收治的90名年龄在49至94岁之间因植入起搏器入院的患者组成。本研究中比较的两种电极都有覆盖离子交换膜的仿形活性炭尖端。除了在其中一种电极的离子交换膜中溶解了30微克地塞米松外，两种电极完全相同。采用正常的电极植入程序。在电极植入后2周以及1、3、6和12个月进行随访程序。将脉冲发生器编程为幅度为2.5或5 V、持续时间为0.5毫秒。使用VARIO功能测量刺激阈值。为了确定微脱位的存在，总共测量了三次阈值。在2周和4周的随访中，类固醇电极的刺激阈值显著低于无类固醇的膜电极（分别为0.54±0.19与0.76±0.25 V，P = 0.0005；以及0.59±0.19与0.74±0.26 V，P = 0.005），但3个月后，两种电极的阈值几乎相同。
